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Case Reports
. 2019 Apr 26:7:2050313X19846043.
doi: 10.1177/2050313X19846043. eCollection 2019.

Hemothorax induced by severe cough: An unusual presentation

Luis Arturo Camarillo-Reyes  1   2 , Roberto Ivan Marquez-Córdova  2   3 , Salim Surani  4 , Joseph Varon  5   6   7   8
Affiliations
Case Reports

Hemothorax induced by severe cough: An unusual presentation

Luis Arturo Camarillo-Reyes et al. SAGE Open Med Case Rep. .

Abstract

Massive hemothorax resulting from cough-induced rib fracture is a condition in which blood accumulates in the chest, compromising the lungs and mediastinal structures. The most common cause of massive hemothorax is acute pro-traumatic injury. We present a case of a 47-year-old gentleman with morbid obesity and psoriasis, who was admitted to the emergency department due to shortness of breath that has been increased progressively after coughing for a period of 2 weeks. Chest radiograph demonstrated a large density in the left hemithorax, collapsing the left lung. Chest computerized tomography showed a left seventh rib fracture and massive pleural effusion. A closed chest tube thoracostomy was performed draining 3 L of hemorrhagic effusion, likely due to bleeding from the intercostal artery tear due to severe and prolonged cough. Cough-induced hemothorax due to spontaneous rib fractures are rare and clinicians should be well aware of this entity to prevent hemorrhagic shock and organ damage.

Keywords: Cough; hemothorax; pleural effusion; tube thoracostomy.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Anteroposterior chest radiograph on arrival to the emergency department shows a large opacity in left hemithorax.
Figure 2.
Figure 2.
Contrast-enhanced computed tomography of the chest reveals a fracture of the seventh left rib in both the mediastinal (Panel A) and the lung window (Panel B) views (see arrows). In addition, a large pleural effusion is depicted in the left hemithorax.
See this image and copyright information in PMC

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